Association of Affirming Care with Chronic Disease and Preventive Care Outcomes among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults.

Experiences of discrimination and bias in healthcare contribute to health disparities for lesbian, gay, bisexual, transgender, and queer populations. To avoid discrimination, many go to great lengths to find healthcare providers who they trust and who are knowledgeable about their health needs. This study examines whether access to an affirming provider improves health outcomes for lesbian, gay, bisexual, transgender, and queer populations across a range of preventive health and chronic disease management outcomes. This cross-sectional study uses Poisson regression models to examine original survey data (n=1,120) from Wave 1 of the Vanderbilt University Social Networks, Aging, and Policy Study, a panel study examining older (aged 50–76 years) lesbian, gay, bisexual, transgender, and queer adults’ health and aging, collected between April 2020 and September 2021. Overall, access to an affirming provider is associated with greater uptake of preventive health screenings and improved management of mental health conditions. Participants with an affirming provider are more likely to have ever and recently received several types of preventive care than participants reporting a usual source of care that is not affirming, including past year provider visit, influenza vaccination, colorectal cancer screening, and HIV test. Access to an affirming provider is also associated with better management of mental health conditions. Inclusive care is essential for reducing health disparities among lesbian, gay, bisexual, transgender, and queer populations. Health systems can reduce disparities by expanding continuing education opportunities; adopting nondiscrimination policies for patients and employees; and ensuring that necessary care is covered by health insurance.

医疗保健中的歧视和偏见经历导致了女同性恋、男同性恋、双性恋、跨性别和酷儿群体的健康差异。为了避免歧视，许多人竭尽全力寻找他们信任且了解其健康需求的医疗服务提供者。本研究考察了获得认可的医疗服务提供者是否能改善女同性恋、男同性恋、双性恋、跨性别和酷儿群体在一系列预防保健和慢性病管理结果方面的健康状况。 这项横断面研究使用泊松回归模型来分析范德堡大学社交网络、老龄化和政策研究第一波的原始调查数据（n = 1120），这是一项针对年龄在50 - 76岁的老年女同性恋、男同性恋、双性恋、跨性别和酷儿成年人的健康和老龄化的小组研究，数据收集于2020年4月至2021年9月之间。 总体而言，获得认可的医疗服务提供者与更多地接受预防健康筛查以及更好地管理心理健康状况有关。与报告通常的医疗服务来源不被认可的参与者相比，有认可的医疗服务提供者的参与者更有可能曾经和近期接受过几种类型的预防保健，包括过去一年的就医、流感疫苗接种、结直肠癌筛查和艾滋病检测。获得认可的医疗服务提供者也与更好地管理心理健康状况有关。 包容性医疗对于减少女同性恋、男同性恋、双性恋、跨性别和酷儿群体之间的健康差异至关重要。医疗系统可以通过扩大继续教育机会、对患者和员工采取非歧视政策以及确保医疗保险涵盖必要的医疗服务来减少差异。